Publisher Correction: Early detection of pulmonary exacerbations in children with Cystic Fibrosis by electronic home monitoring of symptoms and lung function

Horck, Marieke van; Winkens, Björn; Wesseling, Geertjan; Vliet, Dillys van; Kant, Kim van de; Vaassen, Sanne; Groot, Karin de Winter-de; Vreede, Ilja de; Dompeling, Edward

doi:10.1038/s41598-018-36407-y

Cited by 4 publications

(4 citation statements)

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“…Several investigators have reported the use of telehealth or HM in people with CF, but the vast majority have been small feasibility studies with limited external validity. 6–15 Lechtzin et al 17 recently reported the results of the eICE study, the first large multicentre randomised controlled study of HM in CF. The primary outcome (absolute change in FEV1 over the 52-week study period) was negative, with no evidence of slowing lung function decline over the 12-month study period in the HM group.…”

Section: Discussionmentioning

confidence: 99%

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A prospective randomised controlled mixed-methods pilot study of home monitoring in adults with cystic fibrosis

Nash

Choyce

Carrolan

et al. 2022

Ther Adv Respir Dis

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Background: Home monitoring (HM) is able to detect more pulmonary exacerbations (PEx) than routine care (RC) in individuals with cystic fibrosis (CF), but there is currently no evidence for benefits in health outcomes. Patient experiences of using HM and a health economics assessment have not been rigorously assessed to date. This study aimed to assess the effects of HM on hospital admissions, quality of life, antibiotic requirements, exacerbation frequency, lung function, nutritional outcomes, anxiety, depression, costs and health outcomes, as well as the qualitative effects on the patient experience. Methods: This randomised controlled mixed-methods pilot study recruited CF adults cared for in one large regional CF centre. Participants were randomly allocated 1:1 to the intervention cohort [twice-weekly HM of symptoms measured by the Cystic Fibrosis Respiratory Symptom Diary – Chronic Respiratory Infection Symptom Score (CFRSD-CRISS) and forced expiratory volume in one second (FEV1)] or a control cohort (routine clinical care) for the 12-month study period. Measurements were recorded at study visits at baseline, 3, 6, 9 and 12 months. Spirometry, body weight, comorbidities, medications, hospital inpatient days, courses of antibiotics (oral and intravenous) and PEx (defined by the modified Fuchs criteria) were recorded at each study visit. Health status, capability and cost-effectiveness were measured at each study visit by the Hospital Anxiety and Depression Scale (HADS), the ICEpop CAPability measure for Adults (ICECAP-A), EuroQol 5 dimensions (EQ-5D-5L) questionnaire and an adapted resource use questionnaire. The patient experience of HM was assessed by semi-structured qualitative interviews at baseline and 12 months. Results: Eighty-eight participants were recruited, with 44 (50%) randomised to receive HM and 44 (50%) randomised to receive RC. Patient hospital inpatient bed days per annum and overall health-related quality of life were similar between the groups. Protocol-defined PEx requiring intravenous and oral antibiotics were detected more frequently in the HM group, with no other differences between the groups in the secondary outcomes. The total mean National Health Service (NHS) costs were approximately £1500 more per patient for the RC arm than the HM group. The qualitative analysis demonstrated that the patient experience of HM was generally positive and overall the intervention was well accepted. Conclusion: The findings of this trial confirm that HM is effective in detecting PEx in adults with CF. There were no significant differences in hospital inpatient bed days and overall health-related quality of life between the groups. Despite the cost of the HM equipment and the salary of the research fellow to respond to the results, health economics analysis suggests the intervention was less expensive than RC. HM was generally well accepted, with most participants reporting that it resulted in them feeling more empowered and reassured. Trial registration The study protocol was registered with Clinicaltrials.gov (NCT02994706) on 16 July 2014 and published in a peer reviewed journal. Data from this trial has been presented in abstract form at the ECFS Conference in Lyon in September 2020.

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Section: Discussionmentioning

confidence: 99%

“…Since symptoms often gradually deteriorate during a PEx, 5 there has been interest in using home monitoring (HM) to start treatment more promptly and to potentially improve the outcomes of people with CF. 6–17…”

Section: Introductionmentioning

confidence: 99%

A prospective randomised controlled mixed-methods pilot study of home monitoring in adults with cystic fibrosis

Nash

Choyce

Carrolan

et al. 2022

Ther Adv Respir Dis

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“…In fact, several retrospective studies have shown an increase in pulmonary exacerbation or decline in lung function among patients with CF on chronic PPI therapy. [59][60][61] A prior in vitro study demonstrated that primary bronchial epithelial cells stimulated by gastric juice from patients on PPI therapy induced higher IL-8 production than those from patients off PPI. 62 For surgical antireflux therapy, prior retrospective studies, which have largely been limited to case series comparing pre and postsurgical clinical course, have shown a decrease in pulmonary exacerbation rate and an improvement in lung function on PFT after antireflux surgery.…”

Section: Cystic Fibrosis and Gerdmentioning

confidence: 99%

“…However, a definite protective role by medical acid suppression therapy against pulmonary complications of CF has not been demonstrated. In fact, several retrospective studies have shown an increase in pulmonary exacerbation or decline in lung function among patients with CF on chronic PPI therapy 59–61 . A prior in vitro study demonstrated that primary bronchial epithelial cells stimulated by gastric juice from patients on PPI therapy induced higher IL‐8 production than those from patients off PPI 62 .…”

Section: Cystic Fibrosis and Gerdmentioning

confidence: 99%

Extraesophageal syndrome of gastroesophageal reflux: relationships with lung disease and transplantation outcome

Chan

Ahuja

Fisichella

et al. 2020

Annals of the New York Academy of Sciences

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Gastroesophageal reflux disease (GERD) is prevalent and may be associated with both esophageal and extraesophageal syndromes, which include various pulmonary conditions. GERD may lead to pulmonary complications through the "reflux" (aspiration) or "reflex" (refluxate-triggered, vagally mediated airway spasm) mechanisms. While GERD may cause or worsen pulmonary disorders, changes in respiratory mechanics due to lung disease may also increase reflux. Typical esophageal symptoms are frequently absent and objective assessment with reflux monitoring is often needed for diagnosis. Impedance monitoring should be considered in addition to traditional pH study due to the involvement of both acidic and weakly acidic/nonacidic reflux. Antireflux therapy may improve outcomes of some pulmonary complications of GERD, although careful selection of a candidate is paramount to successful outcomes. Further research is needed to identify the optimal testing strategy and patient phenotypes that would benefit from antireflux therapy to improve pulmonary outcomes.

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Clinical outcomes of digital health in adults with cystic fibrosis

Carnovale¹,

Iacotucci²,

Qiao³

et al. 2022

Respiratory Medicine

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Publisher Correction: Early detection of pulmonary exacerbations in children with Cystic Fibrosis by electronic home monitoring of symptoms and lung function

Abstract: A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper.

Cited by 4 publications

References 0 publications

A prospective randomised controlled mixed-methods pilot study of home monitoring in adults with cystic fibrosis

A prospective randomised controlled mixed-methods pilot study of home monitoring in adults with cystic fibrosis

Extraesophageal syndrome of gastroesophageal reflux: relationships with lung disease and transplantation outcome

Clinical outcomes of digital health in adults with cystic fibrosis

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